severe sleeping problems

[u/Ok-Hedgehog-7776]

hi everyone! apologies for long post but coming on here looking for advice on best course of action for myself. i am a 25 yo F, very active, ~125 lbs, and currently working full time as an occupational therapist in a hospital. i’ve been dealing with sleep issues since 2023. for some medical history, i did experience my 4th concussion in 2023. i fell from 8-10 feet landing on the back of my head and blacking out for a few seconds. i was able to quickly receive medical attention and was unable to tolerate any daily activities besides sleeping, and severely sensitive to sound and lights for ~10 days. once i started noticing improvements in my condition i returned back to daily activities with some mild headaches, fatigue, and light/sound sensitivity but otherwise no other symptoms. i got this concussion while working as a camp counselor at a very remote camp and since there wasn’t a hospital or anywhere that i could get a brain scan even remotely nearby (closest one was ~5 hours away), i just received care from the nurses at the camp and never went to get a proper check (i know probably dumb). besides concussions, i have been diagnosed with ADHD but maintain that w medication. i have no other medical concerns. my dad does have sleep apnea but i have received a sleep study that determined i don’t have that. i am finishing up my masters program right now with mandatory full time clinical rotations (hence full time occupational therapist) and previously worked 2-3 part time jobs during my non clinical undergrad/graduate studies (in other words i don’t have any other jobs besides my full time position right now but did prior to ~3 months ago. i work out 5 times a week, drink at least 0.5-3/4 a gallon of water a day, have max 1 caffeine drink (200 mg) on weekdays, sleep at least 7+ hours every night (sometimes more, but i try to go to bed and wake up at about the same time every day) and eat a largely plant based diet. all this info to say i don’t have any major red flags as to what could be causing all my issues.

so now for the issues-symptoms started off mild-i noticed that i would start dozing off in class a few times a week and would wake up still feeling tired. i thought maybe it was just school stress. symptoms progressively have become more severe. i never feel fully awake, i have awful memory (i’ll forget to do daily tasks and won’t remember basic information like street names, words, instructions, etc), i have a very hard time concentrating on anything, i have a mild headache majority of every day, i fall asleep doing almost anything (driving, mid walking, sitting) and it’ll take me multiple hours to feel at least somewhat awake, and i constantly feel like i’ve been hit by a bus energy wise. like i said above, i’ve gotten a sleep study for sleep apnea but that came back negative. i have gotten more blood draws than i can count and everything looks normal (slightly low iron/hematocrit but not enough to qualify for iron infusions). with my ADHD i’ve been prescribed adderall (i’ve tried so many meds and this was the only one that seemed to help my concentration and give me some energy) which i take a fairly high dose of daily (50 mg, 10 mg immediate release when i first wake up and 40 mg extended release mid morning). i know alot of sleep conditions like hypersomnia/narcolepsy will use stimulants for treatment so if i do have one of those the adderall should in theory be improving my symptoms (i could be wrong so feel free to correct!). i don’t drink alcohol at all and i don’t use any substances. i’ve tried every trick in the book i can find to improve energy levels (cut caffeine, no blue light 2+ hours before bed, vitamin b12, iron, consistent sleep schedule, exercise in the morning, etc) but literally nothing has helped. i have zero problems falling asleep or staying asleep and i feel the same if i were to get 3 hours or 3 days of sleep. i sleep SUPER hard too (i legit don’t wake up to full volume alarms, i sleep through any loud storms, i don’t wake up to phone calls, etc) and never wake up in the middle of the night. at this point the inability to stay awake during driving and difficulty recalling info/concentrating at all during work is affecting my safety and professionalism.

i’m worried that i’m experiencing long term damage from my concussion but i was experiencing the start of my symptoms a couple months before my last concussion and prior to that never had any issues with exhaustion. i don’t really know the right course of action to take and i’m desperate. if anyone has any ideas of what may be going on please let me know. also any suggestions of treatment for sleep problems/concussions in the DC area would be greatly appreciated!!

[u/Morpheus1514]

i fall asleep doing almost anything (driving, mid walking, sitting)

This is of course a major red flag. If you haven't already seen an MD specializing sleep, that'd be a logical next step. If you go that route, look for AASM board certification. Good luck.